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Gadobenate dimeglumine-enhanced liver MR imaging: value of dynamic and delayed imaging for the characterization and detection of focal liver lesions

  • Hepatobiliary–Pancreas
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Abstract

The aim of this study was to determine the value of delayed-phase imaging (DPI) of gadobenate dimeglumine (Gd-BOPTA)-enhanced MR imaging for the evaluation of focal hepatic tumors compared with precontrast imaging and early dynamic phase imaging. The MR images were obtained in 48 patients with 98 focal hepatic tumors. Three-dimensional gradient-echo (GRE) imaging obtained before and 30, 60, and 1 h after administration of 0.1 mmol/kg of gadobenate dimeglumine. Each image set was analyzed qualitatively (lesion detection, conspicuity, delineation, and enhancement pattern on DPI) and quantitatively [signal-to-noise ratio (SNR), tumor–liver contrast-to-noise ratio (CNR)]. Improved lesion-to-liver contrast during the dynamic phase imaging was observed compared with precontrast images. The DPI showed a homogeneous enhancement of liver parenchyma and distinctive enhancement features of focal liver lesions: metastases (85%) showed a target shaped enhancement, and hepatocellular carcinomas (HCCs) showed an inhomogeneous (58%) or homogeneous enhancement (21%). The DPI showed better performance for the detection of metastases than other images by increasing lesion delineation (p<0.05). The absolute CNR of metastasis measured from periphery of the tumors on DPI was greater than precontrast and arterial phase imaging (p<0.05). The Gd-BOPTA during both dynamic and delayed phases provides valuable information for the characterization of focal liver lesions, and furthermore, Gd-BOPTA-enhanced DPI contributed to the improved detection of liver metastasis compared to precontrast and early dynamic imaging.

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References

  1. Spinazzi A, Lorusso V, Pirovano G, Kirchin M (1999) Safety, tolerance, biodistribution and MR imaging enhancement of the liver with gadobenate dimeglumine: results of clinical pharmacologic and pilot imaging studies in non-patient and patient volunteers. Acad Radiol 6:282–291

    CAS  PubMed  Google Scholar 

  2. Kirchin MA, Pirovano G, Spinazzi A (1998) Gadobenate dimeglumine (Gd-BOPTA): an overview. Invest Radiol 33:798–809

    CAS  PubMed  Google Scholar 

  3. Vogl TJ, Pegios W, McMahon C, Balzer J, Waitzinger J, Pirovano G, Lissner J (1992) Gadobenate dimeglumine—a new contrast agent for MR imaging: preliminary evaluation in healthy volunteers. AJR 158:887–892

    CAS  Google Scholar 

  4. Cavagna FM, Maggioni F, Castelli PM, Dapra M, Imperatori LG, Lorusso V, Jenkins BG (1997) Gadolinium chelates with weak binding to serum proteins. A new class of high-efficiency, general purpose contrast agents for magnetic resonance imaging. Invest Radiol 32:780–796

    CAS  PubMed  Google Scholar 

  5. Caudana R, Morana G, Pirovano G, Nicoli N, Portuese A, Spinazzi A, Rito R di, Pistolesi GF (1996) Focal malignant hepatic lesions: MR imaging enhanced with gadolinium benzyloxypropionictetra-acetate (BOPTA)—preliminary results of phase II clinical application. Radiology 199:513–520

    CAS  PubMed  Google Scholar 

  6. Spinazzi A, Lorusso V, Pirovano G, Taroni P, Kirchin M, Davies A (1998) Gd-BOPTA clinical pharmacology: biodistribution and MR enhancement of the liver. Acad Radiol 5:S86–S89

    PubMed  Google Scholar 

  7. Petersein J, Spinazzi A, Giovagnoni A, Soyer P, Jerrior F, Lencioni R, Bartolozzi C, Grazioli L, Chiesa A, Manfredi R, Marano P, Van Persijn, Van Meerten EL, Bloem JL, Petre C, Marchal G, Greco A, McNamara MT, Heuck A, Reiser M, Laniado M, Claussen C, Daldrup HE, Rummeny E, Kirchin MA, Pirovano G, Hamm B (2000) Focal liver lesions: evaluation of the efficacy of gadobenate dimeglumine in MR imaging—a multicenter phase III clinical study. Radiology 215:727–736

    CAS  Google Scholar 

  8. Grazioli L, Kirchin M, Pirovano G, Spinazzi A (1999) Multihance in the dynamic phase of contrast enhancement: a pictorial assessment. J Comput Assist Tomogr (Suppl 1)23:S61–S64

    Google Scholar 

  9. Pirovano G, Vanzulli A, Marti-Bonmati L, Grazioli L, Manfredi R, Greco A, Holzknecht N, Daldrup-Link HE, Rummeny E, Hamm B, Arneson V, Imperatori L, Kirchin MA, Spinazzi A (2000) Evaluation of the accuracy of gadobenate dimeglumine-enhanced MR imaging in the detection and characterization of focal liver lesions. AJR 175:1111–1120

    CAS  Google Scholar 

  10. Manfredi R, Maresca G, Baron R, Cotroneo AR, Gaetano AM de, Franco A de, Pirovano G, Spinazzi A, Marano P (1999) Delayed MR imaging of hepatocellular carcinoma enhanced by gadobenete dimeglumine (Gd-BOPTA). J Magn Reson Imaging 9:704–710

    CAS  PubMed  Google Scholar 

  11. Grazioli L, Morana G, Caudana R, Benetti A, Portolani N, Talamini G, Colombari R, Pirovano G, Kirchin MA, Spinazzi A (2000) Hepatocellular carcinoma: correlation between gadobenate dimeglumine-enhanced MRI and pathologic findings. Invest Radiol 35:25–34

    CAS  PubMed  Google Scholar 

  12. Rofsky NM, Lee VS, Laub G, Pollack MA, Krinsky GA, Thomasson D, Ambrosino MM, Weinreb JC (1999) Abdominal MR imaging with a volumetric interpolated breath-hold examination. Radiology 212:876-884

    CAS  PubMed  Google Scholar 

  13. Yu JS, Kim MJ, Kim KW, Chang JC, Jo BJ, Kim TH, Lee JT, Yoo HS (1998) Hepatic cavernous hemangioma: sonographic patterns and speed of contrast enhancement on multiphase dynamic MR imaging. AJR 171:1021–1025

    CAS  Google Scholar 

  14. Sugarbaker PH, Steves MA (1994) Cytoreductive approach to treatment of multiple liver metastases. In: Sugarbaker PH (ed) Hepatobiliary cancer. Kluwer, Boston, pp 13–20

  15. Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S (1983) Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology 148:397–401

    CAS  PubMed  Google Scholar 

  16. Livraghi T, Vettori C (1990) Percutaneous ethanol injection therapy of hepatoma. Cardiovasc Intervent Radiol 13:146–152

    CAS  PubMed  Google Scholar 

  17. McGahan JP, Browning PD, Brock JM, Telsuk H (1990) Hepatic ablation using radio-frequency electrocautery. Invest Radiol 25:267–270

    CAS  PubMed  Google Scholar 

  18. Karhunen PJ (1986) Benign hepatic tumors and tumor-like conditions in men. J Clin Pathol 39:183–188

    CAS  PubMed  Google Scholar 

  19. Helmberger TK, Laubenberger J, Rummeny E, Jung G, Sievers K, Dohring W, Meurer K, Reiser MF (2002) MRI characteristics in focal hepatic disease before and after administration of MnDPDP: discriminant analysis as a diagnostic tool. Eur Radiol 12:62–70

    Article  PubMed  Google Scholar 

  20. Kettritz U, Schlund JF, Wilbur K, Eisenberg LB, Semelka RC (1996) Comparison of gadolinium chelates with manganese-DPDP for liver lesion detection and characterization: preliminary results. Magn Reson Imaging 14:1185–1190

    CAS  PubMed  Google Scholar 

  21. Denys A, Arrive L, Servois V, Dubray B, Najmark D, Sibert A, Menu Y (1994) Hepatic tumors: detection and characterization at 1-T MR imaging enhanced with AMI-25. Radiology 193:665–669

    CAS  PubMed  Google Scholar 

  22. Reimer P, Jahnke N, Flebich M, Schima W, Deckers F, Marx C, Holzknecht N, Saini S (2000) Hepatic lesion detection and characterization: value of nonenhanced MR imaging, superparamagnetic iron oxide-enhanced MR imaging, and spiral CT-ROC analysis. Radiology 217:152–158

    CAS  PubMed  Google Scholar 

  23. Vogl TJ, Schwarz W, Blume S, Pietsch M, Shamsi K, Franz M, Lobeck H, Balzer T, Del Tredici K, Neuhaus P, Felix R, Hammerstingl RM (2003) Preoperative evaluation of malignant liver tumors: comparison of unenhanced and SPIO (Resovist)-enhanced MR imaging with biphasic CTAP and intraoperative US. Eur Radiol 13:262–272

    PubMed  Google Scholar 

  24. Reimer P, Balzer T (2003) Ferucarcotran (Resovist): a new clinically approved RES-specific contrast agent for contrast-enhanced MRI of the liver: properties, clinical development, and applications. Eur Radiol 13:1266–1276

    PubMed  Google Scholar 

  25. Clement O, Siauve N, Cuenod CA, Vuillemin-Bodaghi V, Leconte I, Frija G (1999) Mechanism of action of liver contrast agents: impact for clinical use. J Comput Assist Tomogr 23:S45–S52

    PubMed  Google Scholar 

  26. Mahfouz AE, Hamm B, Wolf KJ (1994) Peripheral washout: a sign of malignancy on dynamic gadolinium-enhanced MR images of focal liver lesions. Radiology 190:49–52

    CAS  PubMed  Google Scholar 

  27. Grazioli L, Morana G, Federle MP, Brancatelli G, Testoni M, Kirchi MA, Menni K, Olivetti L, Nicoli N, Procacci C (2001) Focal nodular hyperplaisa: morphologic and functional information from MR imaging with gadobenate dimeglumine. Radiology 221:731–739

    CAS  PubMed  Google Scholar 

  28. Morana G, Grazioli L, Schneider G, Testoni M, Menni K, Chiesa A, Procacci C (2002) Hypervascular hepatic lesions: dynamic and late enhancement pattern with Gd-BOPTA. Acad Radiol 9 (Suppl 2):S476–S479

    PubMed  Google Scholar 

  29. Gehl HB, Bourne M, Grazioli L, Moller A, Lodemann KP (2001) Off-site evaluation of liver lesion detection by Gd-BOPTA-enhanced MR imaging. Eur Radiol 11:187–192

    CAS  PubMed  Google Scholar 

  30. Yu JS, Kim KW, Jeong MG, Lee JT, Yoo HS (2000) Nontumorous hepatic arterial-portal venous shunts: MR imaging findings. Radiology 217:750–756

    CAS  PubMed  Google Scholar 

  31. Peñē CS, Saini S, Baron RL, Hamm BA, Morana G, Caudana R, Giovagnoni A, Villa A, Carriero A, Mathieu D (2001) Detection of malignant primary hepatic neoplasms with gadobenate dimeglumine (Gd-BOPTA)-enhanced T1-weighted hepatocyte phase MR imaging: results of off-site blinded review in a phase-II multicenter trial. Korean J Radiol 2:210–215

    PubMed  Google Scholar 

  32. Pirovano G, Vanzulli A, Marti-Bonmati L, Grazioli L, Manfredi R, Greco A, Holzknecht N, Daldrup-Link HE, Rummeny E, Hamm B, Arneson V, Imperatori L, Kirchin MA, Spinazzi A (2000) Evaluation of the accuracy of gadobenate dimeglumine-enhanced MR imaging in the detection and characterization of focal liver lesions. AJR 175:1111–1120

    CAS  Google Scholar 

  33. Gabata T, Matusi O, Kadoya M, Yoshikawa J, Ueda K, Kawamori Y, Takashima T, Nonomura A (1998) Delayed MR imaging of the liver: correlation of delayed enhancement of hepatic tumors and pathologic appearance. Abdom Imaging 23:309–313

    CAS  PubMed  Google Scholar 

  34. King LJ, Burkill GJ, Scurr ED, Vlavianos P, Murray-Lyons I, Healy JC (2002) MnDPDP-enhanced magnetic resonance imaging of focal liver lesions. Clin Radiol 57:1047–1057

    CAS  PubMed  Google Scholar 

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Kim, Y.K., Lee, J.M. & Kim, C.S. Gadobenate dimeglumine-enhanced liver MR imaging: value of dynamic and delayed imaging for the characterization and detection of focal liver lesions. Eur Radiol 14, 5–13 (2004). https://doi.org/10.1007/s00330-003-2115-1

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  • DOI: https://doi.org/10.1007/s00330-003-2115-1

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